Barre ́ syndrome: recurrence, treatment-related fluctuation or CIDP?

Guillain–Barre ́ syndrome (GBS) is usually a monophasic illness, but may recur after an interval of many years in 1–6 % of patients.1 The paper by Kuitwaard et al2 from one of the pre-eminent international GBS research groups describes the largest (retrospective) series of 32 patients with recurrent GBS and the first to compare these with non-recurrent GBS (see page 56). Patients with (Miller) Fisher syndrome (FS), younger age (,30 years) and milder disease (ie, ambu-lant) were more likely to have a recurrence: any of these factors at least doubled the risk of recurrence. Patients with FS, pure motor or oculomotor weakness usually experi